December 1, 1999
View Full PaperCognitive decline in individuals with high blood pressure
Structured PICO
Does antihypertensive treatment prevent cognitive decline in elderly individuals with high blood pressure?
P
Population
1,373 elderly individuals (aged 59 to 71 years) from a longitudinal population-based study in Nantes, France.
I
Intervention
Antihypertensive therapy in individuals with high blood pressure (systolic blood pressure ≥160 mm Hg or diastolic blood pressure ≥95 mm Hg)
C
Comparator
No antihypertensive therapy (untreated high blood pressure)
O
Outcome
Cognitive decline (defined as a drop of 4 points or more on the Mini-Mental State Examination between baseline and the 4-year assessment)
High blood pressure is associated with an increased risk of cognitive decline in the elderly, but this risk is substantially reduced in patients receiving antihypertensive treatment.
Abstract
OBJECTIVE: To examine whether baseline high blood pressure and antihypertensive treatment predicts cognitive decline in elderly individuals. METHODS: A longitudinal population-based study of elderly individuals (n = 1,373) in Nantes (western France) was undertaken. Individuals 59 to 71 years of age were selected from electoral rolls. High blood pressure at baseline was defined as systolic blood pressure > or =160 mm Hg or diastolic blood pressure > or =95 mm Hg. Cognitive decline was defined as a drop of 4 points or more on the Mini-Mental State Examination between baseline and the 4-year assessment. RESULTS: There is an association between high blood pressure at baseline and cognitive decline at the 4-year assessment (odds ratio, 2.8; 95% CI, 1.6 to 5.0). In participants with high blood pressure, the risk of cognitive decline was 4.3 (95% CI, 2.1 to 8.8) in those without antihypertensive therapy and 1.9 (95% CI, 0.8 to 4.4) in those being treated. In participants with high blood pressure both at baseline and at the 2-year assessment, the risk for untreated participants was 6.0 (95% CI, 2.4 to 15.0) compared with 1.3 (95% CI, 0.3 to 4.9) in treated participants. CONCLUSIONS: High blood pressure was associated with cognitive decline. In individuals with high blood pressure, cognitive decline occurred in a relatively short time period and the risk was highest in untreated hypertensive patients.